Aims Depression affects 7%–15% of pregnant women. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used pharmacological treatment, but there are concerns regarding neonatal withdrawal symptoms and an increased risk of persistent pulmonary hypertension of the newborn (PPHN). Our aim was to assess the management of babies born to mothers on SSRIs at our hospital.
Methods We retrospectively audited the management of babies born to mothers on SSRIs between August 2015-March 2016. Our audit standard was the hospital guideline which was to observe babies on the postnatal ward for 48–72 hours for signs of withdrawal and to do pre and post ductal oxygen saturations to exclude PPHN.
Results A total of 24 babies were identified. Limited data was available for six babies. Table 1 shows the duration of hospital stay, with 91% of babies staying in hospital for at least 48 hours. The most common withdrawal symptoms occurred in the first 24 hours and included tremors/jittery (8 babies), snuffly (8 babies) and vomiting (5 babies). No baby developed significant withdrawal symptoms (defined as Finnegan score >4) or required intervention for withdrawal. Only two babies had both pre and post ductal oxygen saturations recorded before discharge but none of the babies were admited to the neonatal unit with PPHN.
Conclusion The majority of babies stayed for a minimum of 48 hours but none developed significant SSRI withdrawal. Following the results of this audit we have proposed a new guideline to monitor babies in hospital for 24 hours and, if asymptomatic at this point, to discharge home with daily community midwife visits until day 3 of life. Further work including making the guideline more accessible and educating midwives is required to ensure pre and post ductal oxygen saturations are done before discharge.
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